Strains

• Alternative Names

  Pulled muscle

• Causes
  • Excessive physical activity or effort
  • Improperly warming up before a physical activity
  • Poor flexibility
• Symptoms
  • Pain and difficulty moving the injured muscle
  • Discolored and bruised skin
  • Swelling
• First Aid
  • Apply ice immediately to reduce swelling. Wrap the ice in cloth -- avoid using ice directly on the skin. Apply ice for 10 to 15 minutes every 1 hour for the first day. Then, every 3 to 4 hours.
  • Use ice for the first 3 days. After that, either heat or ice may be helpful.
  • Rest the pulled muscle for at least a day. If possible, keep the pulled muscle elevated above the level of the heart.
  • Avoid using a strained muscle while it is still painful. When the pain subsides, start activity slowly and in moderation.
• Call immediately for emergency medical assistance if
  • You are unable to move the muscle.
  • The injury is bleeding.

  Call your doctor if the pain does not go away after several weeks.

• Prevention
  • Warm-up properly before exercise and sports.
  • Keep your muscles strong and flexible.
• References

  Mercier LR. Sports medicine. In: Mercier LR, ed. Practical Orthopedics. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 15.

  Cohen I, Jouve C. Trapezius strain. In: Frontera, WR, Silver JK, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 8.

  Geiderman JM. General principles of orthopedic injuries. In: Marx J, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 6th ed. St Philadelphia, Pa: Mosby Elsevier; 2006:chap 46.

Review Date: 5/2/2009

Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.